Wednesday, July 18, 2012

About a month ago when in Portland for a track meet I took
it upon myself to get my ferritin levels checked, something I’ve been meaning
to do for a while, but just hadn’t gotten around to. Why, might you ask, did I think I needed to
know what my ferritin levels were? Well,
there are a few reasons, but first and foremost, it was not because I thought I
was sick or my diet was inadequate or I was feeling especially fatigued in my
training and racing. I mean, sure I
would be tired after a hard long run or speed session, but who wouldn’t be and
isn’t that sort of the point of a hard
workout, to push yourself a little beyond your comfort zone before recovering
and doing it all over again?

No, I had my ferritin checked simply because I wanted to
establish a baseline measure for ferritin and to know just how well my body was
storing iron. As an endurance runner, iron plays an important role in our performance and ability to move oxygen via the
red blood cells to our fatigued and damaged muscles.

Ferritin is a naturally occurring protein in the liver,
spleen, bone marrow, muscles, and blood which stores and releases iron as
needed. As a result, ferritin levels
serve as a kind of proxy measure for the amount of iron available and stored in
one’s body. The specifics of these
processes and the different roles of ferritin/iron moving oxygen and muscle
repair are more complex than this non-medical professional needs to attempt to
understand or restate here.

Suffice it to say, if a runner has low amounts of iron in
their body, they will likely not be able to perform as well as expected or
desired. In extreme cases of low iron
levels one can be described as anemic or diagnosed as suffering from anemia. Endurance athletes, especially runners, can
be especially susceptible to lower iron levels, due to losses of iron that
occur through sweating and through foot strike hemolysis in which red blood
cells literally burst and are destroyed by the constant pounding of one’s foot
strike. In general, one is not
destroying a significant portion on one’s run blood cells on their daily runs,
but with higher mileage running, this can begin to add up and be a factor. Menstruating women may also suffer from lower
levels of iron resulting from monthly blood loss. Obviously, it is important to maintain a
reasonably high ferritin level or at least not have your ferritin levels
decline to a level below the normal range.

Researching the topic online, one can find a variety of
different values for the range of normal adult male ferritin levels with low
ferritin described as anywhere from under 10 to under 24
nanograms per milliliter of blood.
Overall, most online sources (for what that is worth) list 20-24 as
low end of normal.

The results of my ferritin test were rather startling, with
my numbers coming back at 22. Wow, I was
admittedly surprised. That is at the
very low end of healthy and borderline anemic (although my hematocrit and
hemoglobin numbers were not high, they were not nearly as close to the low end
of the reference range as the ferritin was).
In my mind I have a pretty healthy and balanced diet for a runner with a
pretty good amount of animal protein. I thought
I ate reasonable, but regular, portions of red meat, the richest and most
readily absorbed source of dietary iron.
But in learning more about this issue, I became more aware that how you
get your iron and with what other foods can enhance or interfere with the iron absorption
process. Iron absorption is improved
with the availability of vitamin C; whereas, calcium inhibits absorption of
iron. These are not one to one ratios,
but rather are guidelines to remember and incorporate into one’s eating habits
to maximize iron absorption. As a
unapologetic meat eater, I haven’t had to change my diet significantly or worry
about where I might get added iron from non-animal sources; however, I am
trying to increase my iron consumption from plant based, as well as animal based, sources and to cook a little more in cast iron pans which is purported to also
add iron to the diet, although I am somewhat skeptical that it can be very
significant.

Now, a month later, I am taking iron supplements in the form
of ferrous sulfate tablets three times a day (3x65mg) with a vitamin C tablet
and avoiding calcium rich foods near the window of time in which I take the
iron supplements. I am also eating more
lean red meat in my meals and paying attention to what I am eating with my iron
rich foods and supplements. For example, am I drinking
milk (dairy or almond) or eating ice cream near the time I am taking the
supplements? Am I having cheese on a
pastrami sandwich (yes I am), and do I need to really worry about every time I
mix a calcium rich food with an iron rich food?
Of course I don’t. Food is a
pretty big aspect of my life and I refuse to have my diet completely dictated
by something like iron absorption vigilance.
But I am admittedly more aware of these things than I was before.

After a month of taking the supplements and rethinking my
iron intake have I noticed anything different?
I think I have. I feel much
stronger and less tired in my legs in my hard workouts especially in longer
intervals and tempo runs and I feel like I am recovering from runs much quicker
than before. I’m actually kind of
excited to get in the right race and really see what happens. It is not like I feel like superman, but I do
feel that little bit more fresh and peppy than before.

Now the question becomes, to what level do I need to or want
my ferritin levels to rise to? Of
course, I want to get the number up to a “healthy” value or more closer to the
average for healthy adult men. However, working
to improve my iron stores and function, brings up another topic, namely that of
supplementing to enhance performance as opposed to supplementing to reach healthy
or average levels. In general, men’s
ferritin levels are found to be between 20 and 380 ng/ml. For me it seems to make sense to get my
ferritin to at least 50, but why not aim for higher? It is fairly widely known these days that
many elite endurance athletes intentionally take iron supplements to bring
their ferritin levels to around 100 ng/ml or above as a means to maximize the
muscle repair and oxygen moving effects of iron in their bodies.

Should consuming supplemental iron in pill or liquid form when
you do not have a shown deficiency be considered a form of performance enhancement? Yeah, it probably should, but what does that
really mean? Isn’t that the point of a
training program and everything that goes into it, performance enhancement? Of course that is the tricky question in
sports today, where do you draw the line for what is or is not acceptable for
performance enhancement, and why? Most arguments
are either based on creating and maintaining a level playing field or around protecting
the health and safety of athletes, especially young athletes. But in all honesty, that seems like a bit of
a farce to me, since the point of training hard to be the best involves intentional
stresses and pushing your body to extremes and beyond what is considered normal
to force it to adapt and get stronger. One is intentionally trying to find an
advantage over your competitors and taking some risks, pushing to the edges of,
and sometimes beyond what is normal or safe.
Like most things in life, the line that has been drawn to divide what is
acceptable and what is not is relatively arbitrary and is based as much on
opinion, convention, and emotions as it is on facts, data, and logic. Am I advocating for the use of drugs in
athletics? Of course not, but I am not
afraid to be honest and talk openly about their place in the bigger picture of training
and competition.

Anyway, since this is my blog and is selfishly about me, back
to the situation at hand. Do I need to
aim for a ferritin value around 100 or higher?
Not necessarily, but we shall see how this all unfolds and progresses
when I get a follow-up ferritin test at the end of two months of
supplementation. Another test might be
how my race results look after my body has had a chance to benefit from the
effects of increasing my iron levels regardless of how close to 100 ng/ml they
reach. Another test might be how long I
am willing to subject my digestive system to the effects of iron supplements,
because there is most definitely a change in the “output”, and it ain’t always
pretty.

About Me

I am a competitive masters runner who races at distances from the 800 meters on the track to the marathon on the roads. As both a fan, coach, and a participant in the sports of running and track and field, this blog is my place to share my thoughts, musings, and ideas about my running, my friend's running, and the world of elite, professional, high school, and collegiate athletics.
Feel free to send ideas, suggestions, comments, and questions through the comments function or by email to:
splitshortsrunningreport@gmail.com